Mental health in the Americas: an overview of the treatment gap

• Published in: Revista panamericana de salud pública Vol. 42; p. e165
• Main Authors: Kohn, Robert, Ali, Ali Ahsan, Puac-Polanco, Victor, Figueroa, Chantal, López-Soto, Victor, Morgan, Kristen, Saldivia, Sandra, Vicente, Benjamín
• Format: Journal Article
• Language: English
• Published: United States Pan American Health Organization (Organizacion Panamericana de la Salud) 01-01-2018; Organización Panamericana de la Salud; Pan American Health Organization
• Subjects: Adolescents; American Indians; Americas; Children; Community mental health services; Disability; Disease; Graves; Health Policy & Services; Health surveys; Indigenous peoples; Latin American cultural groups; Mass media; Mental disorders; Mental health care; Mental health services; Original Research; People with disabilities; professional practice gaps; Public health; Severity; Substance abuse; Substance use disorder; Canada; Colombia; Argentina; United States > US; Guatemala; Chile; Peru; Latin America; Americas; mental health services; professional practice gaps; Mental disorders; servicios de salud mental; lacunas da prática profissional; Américas; brechas de la práctica profesional; Transtornos mentais; Trastornos mentales; serviços de saúde mental
• ISSN: 1020-4989; 1680-5348; 1680-5348
• DOI: 10.26633/RPSP.2018.165

To understand the mental health treatment gap in the Region of the Americas by examining the prevalence of mental health disorders, use of mental health services, and the global burden of disease.
Data from community-based surveys of mental disorders in Argentina, Brazil, Canada, Chile, Colombia, Guatemala, Mexico, Peru, and the United States were utilized. The World Mental Health Survey published data were used to estimate the treatment gap. For Canada, Chile, and Guatemala, the treatment gap was calculated from data files. The mean, median, and weighted treatment gap, and the 12-month prevalence by severity and category of mental disorder were estimated for the general adult, child-adolescent, and indigenous populations. Disability-adjusted Life Years and Years Lived with Disability were calculated from the Global Burden of Disease study.
Mental and substance use disorders accounted for 10.5% of the global burden of disease in the Americas. The 12-month prevalence rate of severe mental disorders ranged from 2% - 10% across studies. The weighted mean treatment gap in the Americas for moderate to severe disorders was 65.7%; North America, 53.2%; Latin America, 74.7%; Mesoamerica, 78.7%; and South America, 73.1%. The treatment gap for severe mental disorders in children and adolescents was over 50%. One-third of the indigenous population in the United States and 80% in Latin America had not received treatment.
The treatment gap for mental health remains a public health concern. A high proportion of adults, children, and indigenous individuals with serious mental illness remains untreated. The result is an elevated prevalence of mental disorders and global burden of disease.